Acute Coronary Syndrome at Altitude: Diagnostic Dilemma on Aconcagua Using Point-of-Care Ultrasound.
Wilderness Environ Med
; 35(3): 356-360, 2024 Sep.
Article
em En
| MEDLINE
| ID: mdl-38720618
ABSTRACT
At the Plaza de Mulas medical tent, located at 4300 m (14,100 ft) along the Normal Route to the 6960â
m (22,837 ft) summit of Aconcagua in Argentina, a Korean male in his 50s with no known medical conditions presented with lightheadedness and shortness of breath. He had taken sildenafil and acetazolamide that morning without improvement. Vital signs on arrival were notable for oxygen saturations in the high 60s with basilar crackles on lung auscultation, concerning for high altitude pulmonary edema. The patient was started on oxygen via nasal cannula and given dexamethasone. History was limited secondary to language barriers, but on review of systems the patient noted mild chest pressure. Bedside cardiac echocardiogram was performed, which revealed a septal wall motion abnormality. The patient was therefore given aspirin and clopidogrel and was flown to a lower trailhead, where he was met by local Emergency Medical Services. A 12-lead electrocardiogram revealed an anterior ST-elevation myocardial infarction, and the patient was taken emergently to the catheterization lab in Mendoza and underwent stent placement with a full recovery.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Sistemas Automatizados de Assistência Junto ao Leito
/
Síndrome Coronariana Aguda
Limite:
Humans
/
Male
/
Middle aged
País/Região como assunto:
America do sul
/
Argentina
Idioma:
En
Revista:
Wilderness Environ Med
Assunto da revista:
SAUDE AMBIENTAL
Ano de publicação:
2024
Tipo de documento:
Article
País de publicação:
Estados Unidos